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General NPI Number Information
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NPI Number | 1023637816
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Entity Type | Organization
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Legal Business Name | OT AT HOME LLC
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Dates
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Enumeration Date | 04/11/2020
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Last Update Date | 04/11/2020
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Provider Practice Location Address
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Address Line | 7 HAWKS LANDING CIR APT 101
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City | VERONA
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State | WI
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Zip | 53593-8043
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Country | US
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Telephone | 920-639-9395
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Fax |
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Provider Business Mailing Address
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Address Line | 7 HAWKS LANDING CIR APT 101
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City | VERONA
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State | WI
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Zip | 53593-8043
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/OCCUPATIONAL THERAPIST
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Name | EMILY SKALETSKI
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Credential |
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Telephone | 920-639-9395
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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